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Medical Reviewer LVN
HCSC - Richardson, TX
BASIC FUNCTION: This position is responsible for performing discharge care coordination and review activities for determining efficiency, effectiveness and quality of medical/surgical services and serving as liaison between providers and Medical and Network Management Divisions. Review service requests, collect clinical and non-clinical data, verify eligibility, determine be...
Training Specialist
HCSC - United States of America
*Please note - those moving forward to next steps will be required to complete a video interview via HireVue for further consideration* *This role will be exclusively in-office and will also require travel up to 50% of the time* Job Purpose: This position is responsible for facilitating learning solution...
Training Specialist
HCSC - Tulsa, OK
*Please note - those moving forward to next steps will be required to complete a video interview via HireVue for further consideration* *Please note - this role will also be exclusively in-office at our Tulsa, OK location* Job Purpose: This position is responsible for facilitating learning solutions, including ...
Senior Performance Consultant
HCSC - Tulsa, OK
BASIC FUNCTION: This position is responsible for performing one or more of the following functions for the department/division: overseeing and conducting needs analysis and assessment; evaluating performance gaps, recommending learning and performance solutions; designing and developing solutions; facilitating delivery of learning interventions; evaluati...
Medical Director
HCSC - Oklahoma City, OK
We are the Health Care Management division of HCSC — a team of dedicated nurses, doctors and other clinicians. Everything we do, and every decision we make, aims to help our members live their most healthy lives. We treat the whole person with integrated pharmacy, physical and mental health care benefits. We're also tackling the social determinants of healt...
Learning Partner
HCSC - United States of America
Job Purpose: This position is responsible for developing and executing education strategy in alignment with the goals of clinical operations/care coordination (across all Government plans) and in alignment to learning methodology and culture; developing and nurturing consultative partnerships across organization; analyzing performance gaps and learning needs; recommending st...
Customer Advocate I
HCSC - Helena, MT
BASIC FUNCTION: Under supervision, this position is responsible for working on the phone all day in a call center to assist members and physicians by responding to telephone and written inquiries in a prompt, accurate and objective manner. Duties include: conducting research; spends approximately 90 of the scheduled time on the phone according to business need. JOB RE...
Senior Program Manager
HCSC - Richardson, TX
Job Purpose: This position is responsible managing one or more highly complex or enterprise-wide program(s) consisting of multiple projects; being accountable for end-to-end delivery of a complex program (could include multiple projects), including managing the cost / budget, schedule & dependencies, resources, scope, quality, and risk; developing the program strategy, supporti...
Sr Reimbursement Specialist
HCSC - Chicago, IL
**POSITION IS LOCATED IN THE CHICAGO HQ OFFICE** **Contract Configuration for hospital and ancillary; strong Claims experience is a MUST** Job Purpose: This position is responsible for interpreting contract language to identify, implement and configure contract rates and provisions into Enterpr...
Appeals Specialist II
HCSC - Downers Grove, IL
**This is a union position** **If chosen to proceed, each candidate will be required to complete a video interview via HireVue** JOB REQUIREMENTS: * High School Degree or GED. * 3 years experience in a customer service role OR in a health insurance or medical environment. * Knowledge of medical terminology to include coding. * Experience and skills t...
Govt Programs Grievance Coord
HCSC - Tulsa, OK
"If chosen to proceed, each candidate will be required to complete a video interview via HireVue." BASIC FUNCTION: This position is responsible for receiving, processing, and responding to all Government Programs Member Grievances (complaints); prepares responses to the member and to Human Services Division (HSD) as required; prepares the Summary of Evid...
Clinical Quality Review Specialist
HCSC - Richardson, TX
We are the Health Care Management division of HCSC — a team of dedicated nurses, doctors and other clinicians. Everything we do, and every decision we make, aims to help our members live their most healthy lives. We treat the whole person with integrated pharmacy, physical and mental health care benefits. We're also tackling the social determinants of health...
Clinical Quality Review Specialist
HCSC - Richardson, TX
We are the Health Care Management division of HCSC — a team of dedicated nurses, doctors and other clinicians. Everything we do, and every decision we make, aims to help our members live their most healthy lives. We treat the whole person with integrated pharmacy, physical and mental health care benefits. We're also tackling the social determin...
Technology Architect - Data
HCSC - Richardson, TX
As the health care industry continues to rapidly transform, our IT team conceives, develops and delivers impactful technology solutions to support access to quality, affordable health care for our members. We are driven by our collective company purpose: To do everything in our power to stand with our members in sickness and in health®. Our IT team unleashes the power of this p...
Systems Specialist- Salesforce
HCSC - Richardson, TX
Job Purpose : This position is responsible for designing enhancements and new business applications and/or information systems solutions using Salesforce through integration of technical and business requirements; serving as technical designer to identify best solution and resulting technical specifications within limits of code environment; linking Business...
